Nutrition & Physical Activity

Nose surgery, or a “nose job”, is one of the most commonly performed procedures worldwide. Some people need nose surgery to improve their breathing or for reconstruction after an injury or skin cancer, while others want to smooth a bump or change the shape of their nose for cosmetic purposes. And some, like you, consider it for reasons related to both form and function.

The septum is the wall in the nose that separates the two nasal cavities. A deviated septum is when the septum is displaced or otherwise inappropriately constructed, leading to symptoms like you mention such as difficulty breathing, as well as snoring, pain, nose bleeds, and difficulty smelling. Septoplasty is surgery that realigns the septum without any cosmetic alterations to the nose. Rhinoplasty is surgery that involves reconstructing or correcting nasal and septum pathways, as well as aesthetically altering the patient’s appearance by reshaping the nose. There is also something known as a nonsurgical nose job, which refers to an approach of using injectable fillers to alter the nose’s appearance. While this can be an option for subtle exterior irregularities, nonsurgical procedures do not address internal structural issues like a deviated septum.

Rhinoplasty can either be performed “open” or “closed” (endonasally). In open rhinoplasty the surgeon cuts the fleshy bit that separates the patient’s nostrils. In closed rhinoplasty there is no exterior cutting, with all surgical work done inside a patient’s nose. Closed rhinoplasty is considered a more difficult procedure, but has a shorter recovery and faster operating time. Open rhinoplasty requires less experience, but has a longer recovery, slower operating time, and risks external scarring.

Every surgery has its risks. Before nose surgery, patients are screened to alleviate the risk for complications. A surgeon will look for risk factors such as a history of respiratory issues, drug use, smoking, medications that thin blood, and predispositions to nasal infection. The most common complication during nose surgery is bleeding, which, except in rare cases, is easily addressed. Infection is also considered rare, but patients are given antibiotics intravenously to help with this risk prior to surgery. Other potential negative effects include blocked nasal airflow (commonly goes away after two to three weeks) or deformities that subsist for more than a year.

Both septoplasty and rhinoplasty can be performed under local or general anesthesia, depending on the exact procedure and the patient’s preference. General anesthesia can be administered either through an orally inserted tube (this method also helps reduce how much blood the patient swallows) or intravenously. Though anesthesia can be dangerous, cases of mortality from its use are rare and predominantly (>50%) involve young children (0-3 years). Cardiac arrest and respiratory system failure are possible complications from anesthesia. Out of roughly 1,000,000 patients given anesthesia over four years, less than 300 cases of cardiac arrest were reported with less than 75 of those resulting in a fatality. Things that increase the risk of anesthesia complications are youth (particularly 0-3 years), eating before surgery (at least eight hours of fasting is required), or being in a rushed/emergency situation.

In deciding between the different procedures, it might be of interest to know what patient’s say about their quality of life after having one done. A survey found that 85% of septoplasty patients with impaired nasal functions (mainly breathing related) report being satisfied with their procedure and found an average increase in a nose health/functionality performance scale from 23/100 to 67/100 following the procedure. Only 40% of rhinoplasty patients reported improved nasal airflow, though this is because many rhinoplasty operations are performed solely for cosmetic purposes. In terms of post-operation nasal appearance and function, 90% of rhinoplasty patients reported feeling satisfied.

If you decide to opt for rhinoplasty, look for a surgeon with experience in plastic surgery of the nose who has a good reputation of patient satisfaction and has before and after photos of their work available. The American Board of Plastic Surgery (ABPS) is the most common body that certifies rhinoplasty surgeons. Rhinoplasty can be a costly procedure, so you may want to call individual surgeons in your area to see what they charge. Insurance may cover surgery for a deviated septum though it usually does not cover purely cosmetic rhinoplasty, so be sure to check your policy before making an appointment.

It is unlikely that either procedure will affect your voice or singing abilities, but be sure to talk with any potential surgeon to determine your own risk depending on what will be done during your surgery. Bandages usually come off from surgery in less than a week. Depending on the extent of the procedure, the healing process can take many months to see final results once swelling and numbness subside.

While you consider a septoplasty or a rhinoplasty, it may be helpful to ask yourself when you began to consider your nose to be an issue. It sounds like your ex-boyfriend’s joking about your nose got a little under your skin. Is this the first time that you remember thinking about your nose this way or have you always felt this way? Has anyone else ever said anything about your nose to make you self-conscious? Because there is a chance that you might be unhappy with the results of a rhinoplasty, it may help to think about if you’re ready for a permanent change to your appearance. Check out some of the Related Q&As below on corrective surgery, surgery for cosmetic reasons, and body image that might address more factors to consider when deciding whether or not to get a procedure done.

After some reflection you might decide to embrace your unique look and opt only to address the breathing concerns associated with your septum. At the end of the day, and as you noted, this decision is really for you and you alone. Whatever option you end up choosing, hopefully you’ll be breathing easier soon!

The truth is you might have been at risk of for straining your back muscles even if you had been doing sit-ups properly. Experts consider the sit-up to be an exercise that has only limited effectiveness in strengthening your core muscles (the muscles that make up your side, abdomen, and back). Fortunately, there are alternatives to sit-ups that are considered safe and effective for maintaining core muscle health and for building abdominal muscle.

As you mention, sit-ups have the potential to lead to back pain. Sit-ups are known to place significant strain on the spinal column, which can result in back problems. In addition to working abdominal muscles, sit-ups work the hip flexors, which attach the lower back to the spine. Overworking the hip flexors can cause back pain when the muscle pulls on the spine. Doing sit-ups on the ground can further strain the lower back because it gets pushed into the ground as you exercise. If sit-ups are performed with arms around the head, you may pull up on the neck and risk injury. Because sit-ups focus exclusively on building a single core muscle (the transverse abdominis) they also risk destabilizing the spine, which relies on a balance of all the muscles of the core to function properly. Thus, experts suggest that core exercise regiments include a balance of exercises designed to strengthen the major muscles of the side, abdomen and back.

The following strength training exercises can work the entire core without leading to the back pain associated with sit-ups:

Consider plank exercises. In this exercise, the body is held up by the arms. Start by lying flat on your stomach. Then, press your body up using your forearms. Stay in this position for 30-60 seconds. You can also do a side plank which focuses more on the oblique muscles. For this exercise, start by lying on your side and then pressing your body up with the forearem closest to the floor. Hang out there for a while — you’ll start to feel the burn.

The “bird dog” is also a great core-strengthening exercise. Start on all fours and raise your left arm and right leg and then alternate to raising your right arm and left leg.

Pilates. This is actually a group of exercises which place special emphasis on developing a strong core. You can look into taking a Pilates course with a trained instructor; there are also a variety of books and videos available that teach proper Pilates technique.

Instead of doing sit-ups, you could also try crunches. To do a proper crunch, lie on your back, bend one knee, and then gently lift your head and shoulders pausing for a moment; then, lie back down. When doing crunches make sure to place your hands below your lower back in order to give it support. Additionally, avoid hollowing out your stomach or pressing your back against the floor during this exercise. Still, if you opt to continue doing sit-ups, make sure to utilize the proper sit-up technique. This will help reduce your risk of injury and maximize overall effectiveness. When doing sit-ups you may also want to consider using an exercise or stability ball, like the one you mentioned, because it will limit the strain placed on the lower back when sit-ups are done on the ground.

If you are experiencing chronic back pain you may want to consider getting checked out by your healthcare provider. Columbia students on the Morningside campus can make an appointment with Medical Services by logging-in to Open Communicator. Morningside students can also look into the option of a personal trainer at Columbia’s Dodge Fitness Center. Columbia students at the Medical Center can make an appointment with Student Health.

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Think it’s time to cancel your gym membership and invest in a pair of toning shoes instead? Not so fast. The current evidence on toning shoes is controversial. Manufacturers claim that lacing up can help people lose weight and tone buttocks, legs, and abdominal muscles. It turns out that the claims surrounding such products don’t have a leg to stand on.

Since they first arrived on the scene, toning shoes have become very popular and are manufactured by many different brands. Athletic shoes are often designed with support and cushioning in mind, whereas toning shoes are engineered specifically to create instability. The idea is that this instability forces the wearer to engage stabilizing muscles further than regular athletic shoes, which results in greater toning of the buttocks, legs, and abdominal muscles.

Some researchers have found that no increase in calorie expenditure or muscle toning results from wearing the shoes. There is even concern that wearing the shoes might alter the gait of their users and could lead to an increased risk of leg and ankle injuries. Companies that produce toning shoes, however, cite research and testing that they have commissioned to back up their claims. Companies also recommend wearing toning shoes for short periods of time for non-vigorous activities.

In 2012, the nation’s consumer protection agency, the Federal Trade Commission, forced several companies to reimburse consumers for making implausible claims. The lawsuits that were filed against some makers of the toning shoes claimed the shoes did not fulfill their promises or caused injury. While these companies have toned down their claims, toning shoes are still on the market. If you’re looking for a way to tone up, toning shoes probably won’t help you be more physically fit than any other shoe. But if you think a brand new pair of kicks will encourage you to walk or become more physically active, whether they are toning shoes or not, it’s a good first step. If you decide to go the toning shoe route, however, take care to be mindful of injury (you may even want to consult with your health care provider before making a purchase).

If you are looking for more opportunities to be physically active in your new kicks and you are affiliated with Columbia, CU Move is an initiative that offers the University community opportunities to learn about and engage in physical activities that support healthy living.

Keep trying, Trying to be Toned!

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On the one hand, your body knows best. That is, taking cues and signals from your body about when to eat (and when to stop eating) is a surefire way to provide your body with what it needs — both in terms of quality and quantity. On the other hand, each body needs a minimum amount of fuel to run efficiently and at its highest potential. Based on your question, it sounds as though you may not be getting the minimum amount of fuel for your body. For most people, hunger is the number one reminder that they need to eat. To boost your hunger and appetite, you might want to consider trying the following tips:

Exercise daily. At least 30 minutes of moderate physical activity each day has been shown to relieve stress, increase energy, and promote a healthy appetite.

Add variety to your regular diet. Sometimes even the foods you enjoy can start to seem boring. Experimenting with new herbs and spices in addition to new foods might be a great way to get excited about eating.

Sometimes, however, poor appetite may be indicative of an underlying health issue. Research has shown that a loss of appetite can be associated with old age, as well as illness and even pregnancy. Illnesses as serious as cancer and as simple as the common cold are all known to decrease appetite. But it’s not always physical: Mental health issues such as depression or anxiety can affect your appetite as well. A few questions to consider: Have you always had a low appetite? Is under-eating something new for you? If so, does this change in appetite or eating habits correlate with any other events or issues going on in your life? If this is a fairly new phenomenon or sudden change, you may want to speak to a health care provider to rule out any underlying issues. Columbia students can log on to Open Communicator to make an appointment with either a medical provider or Registered Dietician at Medical Services.

In the meantime, you can check out What to eat? for an overview of…well, what to eat. Generally, nutrition experts believe that the basis for a good diet is exercise, combined with eating lots colorful fruits and vegetables, whole grains and lean proteins such as poultry, fish, beans and eggs. It is advised that sugary drinks, red meats (beef, pork, lamb), processed meats (bacon, deli meats), and refined grains (white potatoes, white bread, white rice) as well as alcohol be consumed in moderation. Hope this advice whets your apetite!

Congratulations to you for your month Bulimia-free! Hopefully you are getting the support you need to maintain healthy eating. In addition to the psychological distress of Bulimia, there are a number of physiological problems that can develop, of which hair loss is just one. The good news is that hair loss is temporary, but the bad news is that it can take awhile (as you may have been noticing) for hair to return to its previous state. It generally takes 6 to 12 months before hair growth starts to resume normally.

Bulimia is an eating disorder usually characterized by a pattern of eating that involves bingeing (consuming large quantities of food at one sitting) and purging (doing something to expel the consumed food, i.e. forcing oneself to vomit, taking laxatives, or excessive exercise). People with bulimia may become deficient in certain nutrients, may develop a high level of acidity in the body, have poor blood circulation, and are often dehydrated. All four of these conditions on their own can contribute to hair loss. Put them all altogether, plus the psychological stress (another factor hostile to hair), and you have the perfect storm for hair loss.

Hair is made of a protein called keratin, the same protein also found in skin and nails. When your body becomes deficient in protein and certain vitamins, hair growth is one of the first functions to go because the body prioritizes vital organs over hair. Thus, the hair growth cycle becomes disrupted. There are three primary phases of hair growth. On the first stage, hair grows from the root. In the second, hair grows also from the shaft. The final stage is the loss phase. Both nutrient deficiency and gastric problems can result in the first two stages being cut short, leading to premature hair loss. So hair loss occurs because the rate of hair loss increases (a typical individual loses between 50 and 100 hairs per day) and because hair is not being replenished at the same rate. High acidity also makes it harder for hair to thrive, as does dehydration, which makes hair dry and brittle. Poor circulation means less blood flow to the scalp, which further starves hair of nutrients. So all of this explains why it’s taking a while for your hair to return to normal.

Bulimia can also cause complications with kidney, liver, and heart functioning. Excessive vomiting can cause damage to one’s stomach, esophagus, and mouth, because the acidity is harmful to both soft tissue and teeth. So again, the fact that you have stopped your bingeing and purging and are recovering is wonderful news for your health all around, hair included.

Unfortunately, the notion that "a calorie is a calorie" doesn't necessarily hold true. According to that sentiment, 100 calories of fresh strawberries would be equal to 100 calories of chocolate cake. More important than the number of calories are the types of fat and sugar in a delectable dessert. So if you're making a choice between two desserts, both containing 300 calories, where one has most of its calories from fat, and the other from sugar, it is best to compare the types of fat and sugar in the two.

Trans fats are the most harmful. Trans fats are made by heating liquid vegetable oil in the presence of hydrogen gas, a process called hydrogenation. Hydrogenating vegetable oils makes them less likely to spoil and less likely to break down when heated and re-heated at high temperatures. Most of the trans fats come from commercially prepared baked goods, margarines, and processed foods, along with French fries and other fried foods prepared in fast food and other restaurants. Even small amounts of trans fat in the diet can have harmful health effects. Eating even a few calories from trans fats daily, the amount found in a medium order of French fries, raises one’s risk for heart disease by 23 percent. Trans fats also cause more weight gain than other kinds of fats. In 2006, New York City became the first city to ban trans fats.

Saturated fats are less harmful than trans fats. The body produces its own saturated fat so we don’t need to eat it. Saturated fats come mainly from red meat, poultry, seafood, and dairy products (including cheese, milk, and ice cream). A few plants are also high in saturated fats, including coconuts. Saturated fats raise cholesterol levels, both good cholesterol (HDL) and bad cholesterol (LDL). It's a good idea to keep your intake of saturated fats low, about 7% or less of your caloric intake.

Unsaturated fats are the healthiest. They do not increase risk of heart disease and they raise levels of good cholesterol while lowering bad cholesterol. Unsaturated fats are predominantly found in plant foods, such as vegetable oils, nuts, seeds, and avocadoes. Fish also contain unsaturated fats in the form of omega 3 fats. Unlike saturated fats, the human body does not produce its own unsaturated fat. Some research also indicates that unsaturated fats can lower your risk for certain cancers.

So what about sugars? There are many types of sugar, but only two main types of sugar to be concerned with health-wise: natural and added. Natural sugar is found in fruits, vegetables, milk, whole grain foods, yogurt, and most fruit juice. Too much added sugar can contribute to risk for heart disease (by increasing cholesterol), tooth decay, contributing to weight gain, and decreasing the amount of nutrient-rich calories that you consume. The American Heart Association has specific guidelines for added sugar: no more than 100 to 150 calories a day from added sugar, or no more than 6 to 9 teaspoons. In the U.S., the average person consumes more than 22 teaspoons (or 355 calories) of added sugar a day. The biggest added-sugar culprit is soda and the second is sweets (candy and desserts). Cutting down on sodas and sweets is the best way to reduce added sugar, as well as checking out the labels on your cereals, syrups, jams, jellies, and other condiments.

Remember, the body needs sugar and fat to function, it just doesn’t need as much as is typically found in the western diet. Paying attention to portion control — that is, the volume of dessert you put onto your plate — can help you manage your diet as well.

Why did the coffee bean cross the road? To get to his daily grind!* Research has shown that coffee (both decaf and caffeinated) can temporarily increase blood cholesterol levels, which can contribute to an increased risk of heart disease. However, this primarily applies to frequent coffee drinkers (those who sip more than four cups per day) and people with an already heightened risk of developing heart disease.

Before you shut off your coffee maker, it is important to get the facts straight: the cholesterol-raising effect of coffee is actually due to the type of bean used, and not the caffeine content. Decaffeinated coffee is often derived from Robusta beans, which may have slightly higher cholesterol-raising effects. Unlike Arabica beans (generally used for caffeinated coffee), Robusta beans are reported to have a greater ability to stimulate fatty acid production in the body.

In addition, both caffeinated and decaffeinated coffee beans contain the chemical compounds cafestrol and kahweol. These compounds can disrupt the body’s natural regulatory process. Although the exact chemical pathway is still being researched, preliminary findings suggest that cafestrol and kahweol interfere with hormone receptors specific to lipid metabolism and detoxification in the blood stream. This interference can lead to an increase in cholesterol levels.

Experiencing coffee withdrawal already? Not to worry — research has shown that filtering your coffee (no matter the bean type or caffeine level) can minimize any effects on blood cholesterol levels. This is because filters (both paper and mesh) can retain the chemical compounds in the coffee beans that interfere with our cholesterol levels. The same applies to coffee pods. Therefore, unfiltered coffee (such as Scandinavian and Turkish varieties) may have greater effects on cholesterol levels.

While research has been conclusive about the effects of cafestrol and kahweol on cholesterol levels, remember — these effects are temporary, and often only apparent in people who drink more than 4 cups per day. Sticking to filtered coffee and keeping your consumption down can minimize the cholesterol-raising effects. Enjoy!

Seeing the words “natural flavors” on a food label can be confusing. In this case, the first thing to understand is that natural flavors are listed on the label because they have been added to the food. That is, it's not natural to whatever food product you are consuming. Most processed foods, in fact, have flavors (either natural, artificial, or both) added to them during the production process. Flavors are made by “flavorists” in a laboratory, either by blending natural or synthetic chemicals together to enhance taste. Blending chemicals derived from a natural source, such as a plant or animal product, makes natural flavors. Combining synthetic (human-made) chemicals, on the other hand, makes artificial flavors. Therefore, the primary difference between natural and artificial flavorings is in the origin of the chemicals used to produce their tastes.

While the primary chemicals ingested with natural and artificial flavoring may be the same, a big difference between the two types of flavors relates to cost. The search for "natural" sources of chemicals often requires that a manufacturer go to great lengths to obtain a given chemical. Even though this natural chemical may be chemically identical to the version made in a flavorist’s laboratory, it is much more expensive than the synthetic alternative. In the end, natural flavors are neither better in quality nor healthier than their more cost-effective artificial counterparts. In addition, the source of a natural flavor may not match what the label says. Raspberry flavor doesn’t have to come from raspberries, for example.

Despite the natural origins of natural flavors, food companies are not required to disclose the chemicals used to create the flavor. In fact, a flavor could be the result of blending hundreds of unique chemicals. As a consumer, you may want to know what chemicals you are ingesting. If you are interested in getting the facts, you may be able to contact the food company directly. Perhaps they can specify exactly what flavorings are on the ingredient lists. On the other hand, if you are looking to avoid both natural and artificial flavors completely, it is best to avoid processed foods. You can check ingredient lists and packaging for any sign of “natural” or “artificial flavors."

On your marks, get set, go! Staying hydrated while you’re hitting the gym (or the pavement) is extremely important for an active body. While diet soda may boast zero calories and zero sugar, it is not the Holy Grail to achieving a healthy level of hydration. Diet soda does hydrate the body, but not as well as water. Soaking up the following information can help you stick to water and stay hydrated on the field:

Some diet sodas contain caffeine, which has mild diuretic properties and can increase urination. This decreases the amount of water available to the body — quite detrimental if you’re trying to quench your thirst. Caffeine also increases stomach acid levels, which can cause stomach irritation while you are exercising. Lastly, caffeine is addictive and in large quantities can cause insomnia, jitteriness, headaches, anxiety disorders, and fatigue.

Diet sodas contain significant amounts of sodium, which draws water out of the body's cells and can contribute to dehydration.

Sugary sweet sodas may cause your brain to crave other sweets — not ideal if you’re exercising for health and fitness. In a study done on rodents, artificial sweetener caused the animals to steadily increase their calorie consumption.

Both carbonic acid and phosphoric acid are commonly found in sodas. As a result, drinking too much of the bubbly can corrode the enamel of your teeth.

While the FDA has concluded that aspartame is safe for consumption, it has been linked to a number of side effects such as dizziness, migraines, memory loss, diarrhea, and mood swings. If you are concerned about the safety of aspartame, you can always check the labels of the foods and drinks before you buy them. You may also want to consider discussing any concerns with a health care provider, who may be able to suggest other sweetening alternatives. For example, you can give your water a little pizzazz by adding a wedge of lime or lemon.

The bottom line is that water is the best (and cheapest!) hydrator on the market. Moreover, decreasing on your diet soda consumption may be beneficial to your health as well. Check out the related Q&As below for more information. For tips on cutting down, check out Getting off colas, sodas, pop, fiz...oh, whatever! Drink up and keep moving!

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Looking for something that will help you grow as big as a “chia pet?” Chia seeds are edible seeds that come from the desert plant Salvia hispanica, which is grown in Mexico and dates back to Mayan and Aztec cultures. "Chia" means strength, and folklore has it that these cultures used the tiny black and white seeds as an energy booster. Chia seeds are packed with nutrients, and therefore thought to be a healthy addition to your diet. In order to get the nutritional benefits, it is generally recommended to eat 20 grams of chia seeds (a little bit under two tablespoons), twice per day. However, the appropriate amount of chia seeds depends on several factors such as user's age, health, and several other conditions.

Chia seeds contain omega-3 fatty acids, carbohydrates, protein, fiber, antioxidants, and calcium. One ounce (about two tablespoons) contains 139 calories, 4 g of protein, 9 g of fat, 12 g of carbohydrates, 11 g of fiber, plus vitamins and minerals. Chia seeds can be easily added to foods, drinks, and baked goods. They can also be mixed with water and made into a gel.

So what’s all the hype? People eat chia seeds for diabetes, high blood pressure, and to reduce the risk of heart disease and stroke. However, there is currently no good evidence to support chia consumption for these uses. People have also tried using chia seeds as a weight loss aid, as the high fiber content is thought to suppress appetite and ultimately help with weight loss. There’s not much support for this claim. One study found that eating chia seeds had no effects on body weight, body fat, or changes in appetite over a 12-week period. However, studies have shown that a particular variety of chia seeds, marketed under Salba, can reduce certain risk factors for heart disease such as blood pressure, clotting factors, and inflammation.

With all natural supplements come precautions. If you have food allergies (especially to sesame or mustard seeds) or are on high blood pressure medications or blood thinners, ask your healthcare provider before adding chia to your diet. Also, eating chia seeds is not recommended for pregnant or breastfeeding women, as little is known about the risks. Finally, chia seeds are high in alpha-linolenic acid, which in high doses may increase the risk of prostate cancer.